Abstract 16297: Persistent and Delayed Depression Predict All-cause Unplanned Rehospitalisations Following Acute Myocardial Infarction

Abstract

Introduction: Depression following acute myocardial infarction (AMI) is a risk factor for future events and mortality. The aim of this study was to explore the post-AMI trajectory of depression as a risk factor for all-cause unplanned rehospitalisations. Methods: A total of 118 adults (101 men; mean±SD age = 64.76±11.16 years) completed the Cardiac Depression Scale (CDS) during and one month following AMI admission. On the basis of their CDS scores during index admission and 30 days post-AMI (≥ 95 = probable major depression) patients were categorized as having chronic; absent; recovered; or delayed depression. All-cause, unplanned rehospitalisations were sourced from electronic hospital databases (Cerner and TrakCare) from the time of the enrolment admission to census (11 th Dec 2019). Time in the study ranged from 61 days to 4.8 years. Results: A total of 41% of the sample (n = 48) had ≥ 1 all-cause unplanned rehospitalisation following their index AMI admission. Kaplan Meier Survival analyses revealed that worsening or persistent depression trajectories had earlier unplanned rehospitalisations (p < .05). Pairwise Log Rank tests showed that patients with delayed depression had significantly less time to their first all-cause unplanned rehospitalisation compared to those with absent or recovered depression (p < .05). Patients with chronic depression had significantly earlier unplanned rehospitalisations than those with recovered depression (p < .05). Cox Regression analyses revealed that chronic (HR = 9.62109 [95% CI 2.53, 36.62] and delayed depression (HR = 2.94 [95% CI 1.08, 7.97] significantly increased the risk of all-cause unplanned rehospitalisations, after adjusting for time in the study, demographic factors, illness severity, heart disease knowledge, state anxiety and psychological resilience. Conclusions: Persistent or delayed trajectories of depression from admission to 30 days following AMI independently increases the risk of all-cause unplanned hospital readmissions. Patients should be screened for depression during AMI admission and throughout the early adjustment period (2-3 months post-AMI). Further research to increase capacity to predict post-AMI depression trajectories is warranted.